目的 建立大鼠急性心肌梗死缺血再灌注后无复流模型,并初步验证细胞焦亡在其中的发生情况。方法 选用20只标准成年雄性Sprague Dawley大鼠（体质量260~320 g）,随机分为对照组（n=5）和手术组（n=15）。对照组仅穿线冠状动脉,未行结扎;手术组结扎左前降支0.5 h后解除,进行再灌注4 h,以建立无复流模型。通过Evens blue和硫磺素S染色,评估心肌的正常供血区、再灌注区及无复流区,并对两组大鼠心肌组织进行病理分析。结果 对照组大鼠全部存活,未出现无复流现象,心肌组织中未见细胞焦亡。手术组存活13只,形成明确的正常供血区（n=13）、再灌注区（n=13）和无复流区（n=10）。在无复流区的心肌细胞中均观察到细胞焦亡（n=10）,而正常供血区未见（n=0）,再灌注区部分出现（n=4）,差异具有统计学意义（P<0.05）。结论 细胞焦亡现象主要存在于大鼠急性心肌梗死缺血再灌注后无复流区域中,细胞焦亡可能作为一种区域特异性程序性死亡方式,在心肌无复流的发生与发展中发挥重要作用。

Objective To establish a rat model of myocardial no-reflow after acute myocardial infarction with ischemia-reperfusion injury and to preliminarily explore the occurrence of pyroptosis in the affected myocardium. Methods Twenty adult male Sprague-Dawley rats（260-320 g）were randomly divided into a control group（n=5）and a surgical group（n=15）. In the control group,the coronary artery was encircled with suture but not ligated. In the surgical group,the left anterior descending artery was ligated for 30 minutes, followed by 4 hours of reperfusion to induce the no-reflow model. Evans blue and thioflavin S staining were used to evaluate the normal perfusion area,reperfusion area,and no-reflow area of the myocardium. Histopathological analysis was conducted on myocardial tissues from both groups. Results All rats in the control group survived without evidence of no-reflow or pyroptosis in myocardial tissue. In the surgical group, 13 rats survived and showed distinct regions of normal perfusion, 13 with reperfusion, and 10 with no-reflow. Pyroptosis was observed in all no-reflow areas（n=10）, absent in the normal perfusion zones（n=0）, and partially present in the reperfusion zones（n=4）. The differences were statistically significant（P<0. 05）. Conclusions Pyroptosis predominantly occurs in the no-reflow zones following acute myocardial infarction and ischemia-reperfusion injury in rats. As a region-specific form of programmed cell death, pyroptosis may play an important role in the development of myocardial no-reflow.

目的 探讨基于品管圈活动构建健康体检重要异常结果的追踪管理模式对提高电话随访率的影响。方法 选取2022年5月—2023年4月在中山大学孙逸仙纪念医院健康管理中心体检重要异常结果的328例受检者作为研究对象。成立品管圈活动小组,实施追踪管理模式。干预后时间段为2022年11月—2023年4月,期间针对不同样本分别实施了干预措施一至四及全面实施措施,分析随访1个月后成功随访人数。比较干预前后圈员综合能力变化及患者对健康管理中心的满意度。结果 电话随访率在干预措施一实施后为85.02%,干预措施二实施后为88.59%,干预措施三实施后为90.23%,干预措施四实施后为95.27%,全面实施干预措施一至干预措施四后为95.80%,均较干预措施实施前电话随访率（75.91%）有所增长;干预成功随访人数中,复诊率为84.34%（210/249）,全面实施措施后成功随访人数中复诊率为94.74%（216/228）。相较于干预前,干预后,圈员解决问题能力、责任心、沟通协调、团队凝聚力、积极性、品管手法、自信心、和谐感分值均升高（P<0.05）。干预前患者满意度为85.37%,干预后患者满意度为87.80%,干预后满意度有所升高,差异具有统计学意义（P<0.05）。结论 通过开展品管圈活动,使重要异常结果电话随访率明显提高,有利于提升体检机构的服务质量和服务能力,有利于疾病的早发现、早干预。

Objective Exploring the impact of establishing a tracking and management model for important abnormal results of health check ups based on quality control circle activities on improving telephone follow-up rates. Methods A total of 328 subjects with important abnormal results in Health Management Center of Sun Yat-sen Memorial Hospital of Sun Yat sen University from May 2022 to April 2023 were selected. The quality control circle activity group was set and the tracking management mode was carried out. The post intervention period was from November 2022 to April 2023, during which intervention measures 1-4 and comprehensive implementation measures were implemented for different samples. The number of successful follow-up after 1 month of follow-up was analyzed. Changes in the comprehensive ability of the circle staff before and after the intervention and the patients’ satisfaction with the health management center were compared. Results The telephone follow-up rate after intervention 1 was 85. 02%, 88. 59% after intervention 2,90. 23% after intervention 3,95. 27% after intervention 4 and 95. 80% after all intervention,which was higher than 75. 91% before intervention implementation. Among the single intervention individuals, the re-visit rate was 84. 34%（210/249）, and after the comprehensive implementation of measures, the re-visit rate among the successfully intervened individuals was 94. 74%（216/228）. After the intervention,the problem solving ability,responsibility, communication and coordination,team cohesion, enthusiasm,quality control techniques,self-confidence,and sense of harmony all significantly increased（P<0. 05）. The patient satisfaction rate before intervention was 85. 37%, and after intervention it was 87. 80%. The satisfaction rate increased after intervention, and the difference was statistically significant（P<0. 05）. Conclusions Through the quality control circle activities, the telephone follow-up rate of important abnormal results is significantly improved,which is conducive to improving the service quality and service capacity of physical examination institutions,is conducive to the early detection and early intervention of diseases.

目的 初步探究胆管结扎诱导的梗阻性胆汁淤积对大鼠肝细胞的影响。方法 10只Lewis大鼠随机分为对照组和胆汁淤积组,每组各5只,胆汁淤积组采用胆管结扎2周诱导梗阻性胆汁淤积大鼠模型。苏木精-伊红染色和苯胺蓝染色比较组织病理变化,使用生化分析比较两组小鼠肝功能情况。采用改良的两步胶原酶灌注分离原代肝细胞,通过RT-qPCR检测两组小鼠肝细胞标志基因、细胞增殖标志基因以及胆管细胞标志基因的表达情况。结果 与对照组相比,胆汁淤积组肝脏表现为明显的肝组织紊乱和纤维胶原蛋白沉积以及肝功能的损害。胆汁淤积组较对照组的原代肝细胞更高表达细胞增殖标志基因：细胞增殖标志物（Ki67）基因,叉头盒M1蛋白（Foxm1）基因,增殖细胞核抗原（Pcna）基因和肝细胞生长因子（HGF）基因（P<0.05）;胆汁淤积组的原代肝细胞表达更低水平的肝细胞标志基因：白蛋白（Alb）基因,多药耐药相关蛋白2（Mrp2）基因,胆盐输出泵（Bsep）基因和肝细胞连环蛋白1（Catenin1）基因（P<0.05）,同时表达更高水平的胆管细胞标志基因：细胞角蛋白7（Ck7）基因,细胞角蛋白 19（Ck19）基因,胆管细胞多药耐药性蛋白1（Mdr1）基因和胆管细胞囊性纤维化跨膜传导调节因子（Cftr）基因（P<0.05）以及肝祖细胞标志基因：上皮细胞黏附分子（Epcam）基因和Y染色体性别决定区-盒转录因子9（Sox9）基因（P<0.05）。结论 胆汁淤积可诱导肝细胞向胆管细胞特性转化的可塑性。

Objective To explore the effect of bile duct ligation induced obstructive cholestasis on rat hepatocytes. Methods Ten Lewis rats were randomly divided into control group and cholestasis group, and the cholestasis was induced by bile duct ligation for 2 weeks. The histopathological changes were compared by H&E and aniline blue staining and the liver function was compared by biochemical analysis. Primary hepatocytes were isolated by modified two-step collagenase perfusion, and the expressions of hepatocyte marker genes, cell proliferation marker genes and cholangiocyte marker genes were detected by RT-qPCR. Results Compared with the control group,the liver of the cholestatic group showed obvious disordered histopathology, deposition of fibrous collagen and impaired liver function. Compared with the control group, the primary hepatocytes in the cholestasis group expressed higher cell proliferation-related genes（Ki67,Foxm1,Pcna and HGF）（P<0. 05）. Primary hepatocytes in the cholestasis group expressed lower levels of hepatocyte marker genes（Alb,Mrp2,Bsep and Catenin1）（P<0. 05）,and higher levels of cholangiocyte marker genes（Ck7,Ck19,Mdr1 and Cftr）（P<0. 05）and higher levels of the hepatic progenitor cell marker genes（Epcam and Sox9）（P<0. 05）. Conclusions Cholestasis induces rat hepatocyte plasticity in the transformation into bile duct properties.

       目的   研究SOCS6/STAT6通路在前列腺细胞炎性增殖作用中的调控作用。方法  使用人前列腺细胞株RWPE-1建立炎症模型，将细胞分为对照（CON）组和炎症刺激（INF）组，后者通过添加脂多糖（LPS）模拟炎症环境。采用ELISA检测白细胞介素-1β（IL-1β）-1β、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）表达水平，蛋白免疫印迹法检测细胞因子信号抑制物-6（SOCS6）、信号转导和转录激活因子-6（STAT6）及磷酸化STAT6蛋白的表达水平。结果  经过LPS处理后，RWPE-1细胞中的SOCS6蛋白表达水平显著下降（P＜0.01），而磷酸化STAT6表达水平上升（P＜0.01）。结论  SOCS6/STAT6通路可能通过调节炎症环境下STAT6的磷酸化水平，参与调节前列腺细胞的炎性增殖作用。

       Objective   To explore the  regulatory  role of  SOCS6/STAT6  pathway in the inflammatory  proliferation of 

prostate cells．Methods  The human prostate cell line RWPE-1 was used to establish an inflammation model．Cells were divided into a control（CON）group and an inflammation-stimulated（INF）group，with the latter subjected to lipopolysaccharide（LPS）treatment to simulate an inflammatory environment．The expression levels of interleukin（IL）-1β、IL-6 and  IL-8 were detected by ELISA，and the expression levels of suppressor of cytokine signaling 6（SOCS6），signal transducer and activator oftranscription-6，（STAT6），and phosphorylated STAT6 proteins were detected by Western blot．Results  The  results showed that after LPS treatment，the expression of SOCS6 protein in RWPE-1 cells significantly decreased，while the expression of phosphorylated STAT6 increased．Conclusions  The SOCS6/STAT6 pathway may be involved in  regulating the inflammatory proliferation of prostate cells by modulating the phosphorylation level of STAT6 under inflammatory conditions．

       目的   对比乏白细胞富血小板血浆（LP-PRP）与富白细胞富血小板血浆（LR-PRP）联合体外冲击波疗法（ESWT）治疗慢性非止点跟腱腱病（NIAT）的临床价值。方法   选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者，以随机数表法分为两组，即对照组和观察组各40例，观察组予LP-PRP联合ESWT治疗，对照组予LR-PRP联合ESWT治疗；于治疗前、第一次治疗后1个月、3个月比较两组疼痛度［视觉模拟量表（VAS）评分］、跟腱病变程度［维多利亚体育研究所跟腱评估问卷（VISA-A）］、跟腱功能（Arner-Lindholm跟腱功能评分），并比较两组并发症的发生率。结果   两组在治疗后1个月、3个月的VAS评分下降，VISA-A评分升高，且观察组治疗后3个月的VAS评分（1.05±0.31）分低于对照组的（1.82±0.45）分，VISA-A评分（83.35±5.58）分高于对照组的（76.28±5.35）分（F组间与时点交互=338.478、106.663，均P＜0.05）；治疗后3个月，观察组跟腱功能（优、良、差各有24、13、3例）优于对照组（优、良、差各有14、16、10例），差异有统计学意义（Z=2.529，P=0.012）。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义（均P＞0.05）。结论   与LR-PRP比较，LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度，改善患者跟腱功能。

       Objective  To compare the clinical value of leukocyte-poor platelet rich plasma（LP-PRP）and leukocyte-rich platelet rich plasma（LR-PRP）combined with extracorporeal shock wave therapy（ESWT）in the treatment of chronic non insertional Achilles tendinopathy（NIAT）．Methods 

Eighty patients with chronic NIAT admitted to Ganzhou People’s Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method：a control group and an observation group，with 40 patients in each group．The observation group received LP-PRP combined with ESWT treatment，while the control group received LR-PRP combined with ESWT treatment．The pain level（Visual Analog Scale［VAS］score），degree of Achilles tendon lesion（Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire［VISA-A］），and Achilles tendon function（Arner Lindholm Achilles tendon function score）between the two groups were compared before treatment，one month after the first treatment，and three months after treatment，as well as the incidence of complications between the two groups．Results  The VAS scores of both groups decreased and the VISA-A scores increased at one and three months after treatment．The VAS score of the observation group（1.05±0.31）was lower than that of the control group（1.82±0.45）at three months after treatment，while the VISA-A score of the observation group（83.35±5.58）was higher than that of the control group（76.28±5.35）（interaction between group and time point F=338.478，106.663，both P＜0.05）．After three months of treatment，the Achilles tendon function of the observation group（24 cases of excellent，13 cases of good，and three cases of poor）was better than that of the control group（14 cases of excellent，16 cases of good，and  10 cases ofpoor），and the difference was statistically significant（Z=2.529，P=0.012）．There was no  statistically  significant difference in VAS score，VISA-A score，and Achilles tendon function between the two groups one month after treatment（all P＞0.05）．Conclusions  Compared with LR-PRP，LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT，and improving Achilles tendon function．

       目的   评价血塞通联合右美托咪定对脑缺血再灌注损伤大鼠的脑保护效果。方法   选择老龄雄性Wistar大鼠50只，随机分为假手术（C）组、脑缺血再灌注（R）组、血塞通（P）组、右美托咪定（D）组，血塞通联合右美托咪定（PD）组，每组各10只。根据组别给予不同药物，行神经行为学测试；于第3、7天，测量脑梗死面积、脑水含量，以及超氧化物歧化酶（Superoxide dismutase，SOD）、谷胱甘肽过氧化酶（Glutathione peroxidase，GSH-PX）活性测定。结果   给药后第3、5、7天，与P、D组相比，PD组神经行为学评分改善更加显著（P＜0.001）；给药后第3、7天，与P组相比，PD组脑梗死面积、脑水含量均降低（P=0.01，P=0.002），SOD、GSH-PX活性升高显著（P=0.03，P=0.001）；与D组相比，PD组脑梗死面积、脑水含量也显著降低（P＜0.01，P=0.008）；SOD、GSH-PX活性升高显著（P=0.009，P＜0.001）。结论   血塞通联合右美托咪定较单独应用药物，能显著减轻缺血再灌注损伤造成的脑损害，具有脑保护作用。

       Objective  To explore the effects of Xuesaitong combined with dexmedetomidine on cerebral ischemia-reperfusion in elderly rats．Methods  Fifty elderly male Wistar rats were randomly divided into 5 groups：sham operation（C）group，cerebral ischemia-reperfusion（R）group，Xuesaitong（P）group，dexmedetomidine（D）group，Xuesaitong combined with dexmedetomidine（PD）group．Xuesaitong was given in group P，dexmedetomidine was given in group D，and normal saline was given in group C and group R，continuously for 7 days．After 3- and 7-day treatment，the brain of rats was dissected out to assay the area of cerebral infarction，degree of cerebral edema，superoxide dismutase（SOD） and glutathione peroxidase（GSH-PX） activity．Results  When compared PD group with P and D group，neurobehavioral score was lower at 3，5，7 day（P＜0.001）；area of cerebral infarction，degree of cerebral edema were less（P=0.01，P=0.002），activity of SOD and GSH-PX were higher at 3，7 days（P=0.03，P=0.001）respectively．When compared PD group with D group，area of cerebral infarction，degree of cerebral edema were less（P＜0.01，P=0.008），activity of SOD and GSH-PX were higher at 3，7 days（P=0.009，P＜0.001）respectively．Conclusions  The combination of Xuesaitong and dexmedetomidine can obviously reduce the damage by cerebral ischemia-reperfusion in elderly rats and has brain protective effects．

      目的   回顾分析高原地区儿童阑尾炎术后早期炎性肠梗阻的临床特征，总结治疗经验。方法   回顾分析青海省妇女儿童医院2019—2023年收治的49例儿童阑尾炎术后早期炎性肠梗阻病例资料。结果   纳入研究的49例患儿，阑尾炎发病时间3～8 d，平均（5.38±1.25）d，术后出现肠梗阻时间3~11 d，平均时间（4.81±1.70）d，其中48例经过保守治疗后梗阻解除，恢复排气、排便，肠功能恢复时间4~13 d，平均（5.93±2.49）d，1例经积极保守治疗后病情进展，最终经手术治愈。49例患儿均顺利治愈出院，住院时间10～26 d，平均（15.69±3.79）d。术后随访1～2年，患儿饮食、排便均无异常。结论   高原地区儿童阑尾炎术后早期粘连性肠梗阻预防是关键，采取保守治疗同样可获得较高的治愈率，若保守治疗无效或病情进展应及时积极采取手术治疗。

       Objective  To review the clinical characteristics of early postoperative inflammatory small bowel obstruction（EPISBO） in children with appendicitis in plateau area and summarize the treatment experience．Methods  The data of 49 cases of appendicitis EPISBO in children admitted to Qinghai Women and Children’s Hospital from 2019 to 2023 were  retrospectively analyzed．Results  The onset time of appendicitis was 3-8 days，with an average of（5.38±1.25）days，and the time of intestinal obstruction was 3-11 days after surgery，with an average of（4.81±1.70）days．After conservative treatment，48 cases were relieved of obstruction，resumed exhaust and defecation，and intestinal function recovered in 4-13 day，average（5.93±2.49）d，1 case had progression after conservative treatment，and was cured by surgery．All the 49 children were successfully cured and discharged．The length of hospital stay was 10-26 days，with an average of（15.69±3.79）days．Postoperative follow-up of 1 to 2 years showed normal eating and bowel movements．Conclusions  The prevention of EPISBO in children with appendicitis in plateau area is the key．Conservative treatment can also achieve a higher cure rate．If conservative treatment is ineffective or the disease progresses，timely surgical treatment should be provided．

        当前公立医院面临的内外部环境十分复杂，各种不确定因素影响公立医院健康运营。引入内部控制理念，建立健全采购与付款环节是必要的。文章对目前公立医院采购与付款业务管理中存在的问题进行分析，从改善内部环境建设、建立起有效的风险评估体系、加强采购与付款业务控制活动、巩固监督检查体系、加强信息沟通建设五个方面提出相应策略，优化公立医院采购与付款环节内部控制，从而减少风险带来的不确定性，保障医院运行的效率效益，助力医院高质量持续发展。

      Public hospitals are currently navigating a complex internal and external environment，where  various uncertainties can impact their effective operation．The introduction of internal control concepts and the establishment of  robust procurement and payment processes are essential．This paper analyzes the issues present in the management of procurement and payment operations within public hospitals．It proposes strategies across five key areas：enhancing the internal environment，establishing an effective risk assessment framework，strengthening control activities in procurement and payment processes，reinforcing the supervision and inspection system，and improving information communication．These  strategies aim to optimize internal controls，reduce uncertainty associated with risks，ensure operational efficiency，and support the sustainable，high-quality development of public hospitals．

       目的   探讨、对比休克指数（SI）与血乳酸水平预测院前创伤性休克患者预后中的应用。方法   于2020年12月—2023年12月收治80例创伤性休克患者，均接受SI、乳酸水平的监测。结合监测的结果进行分组：乳酸正常组：乳酸水平在2 mmol/L以下，升高组：2 mmol/L以上；SI正常组：SI在0.9以下，升高组：SI在0.9以上。观察、记录患者入院7 d后的序贯性器官功能衰竭评分（SOFA），对多器官功能障碍综合征（MODS）情况进行评估。同时观察、记录机械通气、血管活性药物的使用和住院等情况。结果   乳酸水平升高组60例，正常组20组；SI升高组58例，正常组22例，女性乳酸水平、SI，与男性比较差异无统计学意义（P＞0.05）。是否发生多器官功能障碍者的年龄、性别、SI指数比较差异无统计学意义（P＞0.05）；格拉斯哥昏迷评分（GCS）评分［（4.22±1.53）分 vs （9.46±3.82）分，t=7.816，P＜0.001］、住院时间［（23.34±5.71）d vs （12.26±2.11）d，t=11.830，P＜0.001］、基础乳酸值［（4.75±2.36）mmol/L vs （2.04±1.11）mmol/L，t=6.721，P＜0.001］与发生MODS在组间对比差异有统计学意义。SI升高组的容量复苏收缩压＞80 mmHg（%）有27例，与乳酸水平升高组比较差异有统计学意义（P＜0.05）（46.55% vs 18.18%，χ ² =12.237，P＜0.001）。乳酸水平升高组中，11例患者接受机械通气，乳酸水平均升高（P＜0.05）；9例患者使用血管活性药物，乳酸水平均升高，比较差异无统计学意义（P＞0.05）；38例住院患者，24例乳酸水平升高（P＜0.05）。13例患者接受机械通气，12例SI升高，比较差异无统计学意义（P＞0.05）；11例患者接受血管活性物治疗，8例SI升高，比较差异无统计学意义（P＞0.05）；39例患者住院，SI升高22例，比较差异有统计学意义（P＜0.05）。结论   针对重症的创伤性休克患者，当血乳酸水平升高时会大大增加MODS发生的概率，乳酸水平在对重症创伤性休克患者预后进行预测时，应用价值更高。

       Objective  To explore and compare the application of shock index（SI）and  blood lactic acid level in predicting the prognosis of patients with pre-hospital traumatic shock．Methods  From December 2020 to December 2023，80 patients with traumatic shock were enrolled，and their SI and levels of lactic acid were monitored．Patients were grouped according to the monitoring results：normal group：lactic acid level below 2 mmol/L，increased group：above 2 mmol/L；normal group：SI below 0.9，and increased group：SI above 0.9．The sequential organ failure score（SOFA）was observed and recorded 7 days after hospitalization，and the situation of multiple organ dysfunction syndrome（MODS）was evaluated．At the same time，mechanical ventilation，the use of vasoactive substances and hospitalization were observed and recorded．Results  There were 60 cases in the group with increased lactic acid level and 20 cases in the normal group．There were 58 cases of increased SI and 22 cases of normal．The lactic acid level and SI index in women were higher than those in men，with no difference（P＞0.05）．There were no differences in age，sex，SI index and the incidence of MODS（P＞0.05）．GCS score（4.22±1.53 vs 9.46±3.82），hospitalization days（23.34±5.71 vs 12.26±2.11）d，basal lactate value（4.75±2.36 vs 2.04±1.11）mmol L-1 were significantly different from those of MODS（t=11.830，P＜0.001；t=6.721，P＜0.001，P＜0.05）．There were 27 cases with volume  resuscitation systolic blood pressure ＞ 80 mmhg（%）in the group with increased SI，which was different from that of SI and lactic acid（46.55% vs18.18%，χ ² =12.237，P＜0.001；P＜0.05）．Lactic acid increased group：11 patients received mechanical ventilation，and the lactic acid levels of all 11 patients increased（P＜0.05）．Nine patients used vasoactive substances，and their lactic acid levels all increased，with no significant difference（P＞0.05）．Of the 38 inpatients，24 cases had elevated lactic acid levels（P＜0.05）．Thirteen patients received mechanical ventilation，and 12 patients had elevated SI，with no statistical significance（P＞0.05）．Eleven patients were treated with vasoactive agents，and 8 patients had increased SI，with no difference（P＞0.05）．Among the 39 patients hospitalized，22 cases had increased SI，and the difference was statistically significant（P＜0.05）．Conclusions  For patients with severe traumatic shock，when the blood lactic acid level increases，the probability of MODS will be greatly increased．Compared with SI index，lactic acid level has higher application value in predicting the prognosis of patients with severe traumatic shock．

       目的   探讨不同清洗方法对聚甲基丙烯酸甲酯（PMMA）骨水泥附着的骨科外来医疗器械清洗效果。方法   以河源地区某三级医院消毒供应中心2023年7—12月同型号PMMA骨水泥术后附着的215件骨科外来医疗器械为研究对象，所有器械均为不锈钢材质，表面光滑，无明显磨损，利用随机数字表将其分为对照组与观察组。对照组（107件）采用常规预处理后清洗消毒器清洗，观察组（108件）预处理采用95%乙醇浸泡15 min后联合快干增亮剂清洗消毒器清洗。比较两种不同清洗方法的清洗效果。结果   观察组的器械清洗消毒后更加光滑且清洁，对照组的器械表面有部分磨损且仍存在一定程度的残留物。采用10倍光源放大镜清洁度检查，对照组清洗合格100件，清洗合格率为93.5%；观察组清洗合格108件，清洗合格率为100%。采用杰力试纸法检测，观察组清洗合格率为100%，对照组清洗合格率为94.4%，采用快速检测三磷酸腺苷（ATP）生物荧光法检查，观察组清洗合格率为99.1%，对照组清洗合格率为93.5%，观察组的清洗合格率高于对照组，差异有统计学意义（P＜0.05）。结论  PMMA骨水泥附着的骨科外来医疗器械采用95%乙醇浸泡15 min后联合快干增亮剂和清洗消毒器可以提高清洗合格率以及外来器械再处理技术的安全性，为安全质量管理提供了有利依据。该技术适合推广使用，能有效排除医疗隐患，确保医疗安全。

       Objective  To compare the cleaning effects of  different methods on external orthopedic medical  devices contaminated with PMMA bone cement．Methods  A total of 215 external orthopedic medical devices contaminated with PMMA bone cement were selected from the disinfection supply center of a tertiary hospital in Heyuan from July to December 2023．All devices were made of stainless steel，with smooth surfaces and no significant abrasion．The devices were randomly divided into control group and observation group using a random number table．The control group（107 devices）was cleaned using conventional pre-treatment followed by a cleaning and disinfection machine．The observation group（108 devices）was pre-treated by soaking in 95% medical ethanol for 15 minutes，followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine．The cleaning effects of the two methods were compared．Results  The study showed that the devices in the observation group were smoother and cleaner after cleaning and disinfection，while the devices in the control group had some abrasion and residual contaminants．Using a 10 x magnifying glass to check cleanliness，the control group had 107 devices passed the cleaning test，with a pass  rate of 93.5%，while the observation group had 108 devices passed，with a pass rate of 100%．Using the Geri test paper method，the observation group had a cleaning pass rate of 100%，and the control group had a pass rate of 94.4%．Using the ATP bioluminescence method，the observation group had a cleaning pass rate of 99.1%，and the control group had a pass rate of 93.5%．The cleaning pass rate of the observation group was higher than that of the control group，with a statistically significant difference（P＜0.05）．Conclusions  Soaking external orthopedic medical devices contaminated with PMMA bone cement in 95% medical ethanol for 15 minutes，followed by cleaning with a quick-drying brightener and a cleaning and disinfection machine，can improve the cleaning pass rate and enhance the safety of reprocessing external devices．This technique provides a  strong basis for  safety and quality management，is suitable for widespread use，which effectively eliminates medical hazards，and ensures medical safety．